期刊
JOURNAL OF CRITICAL CARE
卷 48, 期 -, 页码 124-129出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jcrc.2018.08.028
关键词
Sleep; Critical illness; Electroencephalography; Polysomnography; Encephalopathy; Delirium
资金
- Claude D. Pepper Older Americans Independence Center at Yale [P30 AG021342]
- CTSA grant from the National Center for Advancing Translational Science [KL2 TR000140]
- National Heart, Lung and Blood Institute [K24 HL132093]
- Patrick and Catherine Weldon Donaghue Medical Research Foundation
Purpose: Critically ill patients experience significant sleep disruption. In this study of ICU patients with delirium. we evaluated associations between the loss of stage N2 features (K-complexes, sleep spindles), grade of encephalopathy based on electroencephalography (EEG), and intensive care unit (ICU) outcomes. We hypothesized that loss of stage N2 features is associated with more severe grades of encephalopathy and worse ICU outcomes including death. Materials and methods: This was an observational cohort study of 93 medical ICU patients without primary acute brain injury who underwent continuous EEG. Type and severity of critical illness, sedative-hypnotic use, length of stay, modified Rankin Scale at hospital discharge, and death during hospitalization were abstracted from the medical record. EEG was evaluated for grade of encephalopathy and sleep features. Results: Patients without K-complexes or without sleep spindles had more severe encephalopathy and higher odds of death. The odds ratio for patients without K-complexes was 18.8 (p = .046). The odds ratio for patients without sleep spindles was 6.3 (p = .036). Conclusions: Loss of stage N2 features is common and associated with more severe encephalopathy and higher odds of death. The absence of either Stage N2 feature, K complexes or sleep spindles. may have important prognostic value. (C) 2018 Elsevier Inc. All rights reserved.
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